Sleep study (overnight, in lab)
Facility: Morris County Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,458
- Cash Discount Price: $1,241
- vs. Medicare Baseline: 1.66x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $877.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Multiplan-All Plans | $109 - $3,364 | 12% |
| Coventry Mcr | $109 - $1,458 | 12% |
| Blue Cross Blue Shield | $114 - $1,458 | 13% |
| UnitedHealthcare | $114 - $3,738 | 13% |
| Va Ccn-All Plans | $114 - $1,458 | 13% |
| Choice Care Mcr Adv-All Plans | $117 - $1,458 | 13% |
| Aetna | $252 - $3,349 | 29% |
| Cigna | $2,704 | 308% |
| Coventry Comm-All Other Plans | $3,364 | 383% |
| Providrs Care (Wppa)(Nexus)-All Plans | $5,607 | 639% |
Consumer Guidance & Cost Commentary
For this sleep study procedure at Morris County Hospital in Council Grove, KS, the facility's cash median price of $1,241 is notably lower than the state average of $2,081, offering a potential savings of approximately $840 for patients paying out-of-pocket. While the hospital's negotiated rate of $1,458 is close to the state average, it remains significantly below the gross charge of $2,069, which can sometimes lead patients to mistakenly believe they are paying full price. It is important to note that for individuals with high-deductible plans, paying the cash price of $1,241 upfront may be more cost-effective than using insurance, as the negotiated rate of $1,458 could exceed the patient's out-of-pocket maximum or deductible threshold. Patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The facility's pricing structure aligns with federal benchmarks, as the Medicare rate of $877.34 serves as the objective baseline for evaluating commercial markups. Although the commercial negotiated rate is higher than the Medicare amount, it is well below the typical 200% to 300% markup often seen in commercial billing, suggesting a relatively fair pricing model for in-network coverage. However, patients must be cautious of balance billing if their insurance does not cover the full negotiated amount, as the difference between the allowed rate and the patient's responsibility could result in unexpected costs. To ensure accuracy, consumers should request a detailed, itemized bill rather than accepting a summary invoice, which may obscure specific charges or unbund